Document Detail


The prevalence of celiac disease among patients with nonconstipated irritable bowel syndrome is similar to controls.
MedLine Citation:
PMID:  21762658     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Guidelines recommend that patients with symptoms of nonconstipated irritable bowel syndrome (NC-IBS) undergo testing for celiac disease (CD). We evaluated the prevalence of CD antibodies, and biopsy confirmed CD among patients with NC-IBS in a large US population.
METHODS: In a study conducted at 4 sites, from 2003 to 2008, we compared data from 492 patients with symptoms of NC-IBS to 458 asymptomatic individuals who underwent colonoscopy examinations for cancer screening or polyp surveillance (controls). All participants provided blood samples for specific and nonspecific CD-associated antibodies. Additionally, patients with IBS were analyzed for complete blood cell counts, metabolic factors, erythrocyte sedimentation rates, and levels of C-reactive protein and thyroid-stimulating hormone. Any subjects found to have CD-associated antibodies were offered esophagogastroduodenoscopy and duodenal biopsy analysis.
RESULTS: Of patients with NC-IBS, 7.3% had abnormal results for CD-associated antibodies, compared with 4.8% of controls (adjusted odds ratio, 1.49; 95% confidence interval: 0.76-2.90; P=.25). Within the NC-IBS group, 6.51% had antibodies against gliadin, 1.22% against tissue transglutaminase, and 0.61% against endomysium (P>.05 vs controls for all antibodies tested). CD was confirmed in 0.41% of patients in the NC-IBS group and 0.44% of controls (P>.99).
CONCLUSIONS: Although CD-associated antibodies are relatively common, the prevalence of CD among patients with NC-IBS is similar to that among controls in a large US population. These findings challenge recommendations to routinely screen patients with NC-IBS for CD. More than 7% of patients with NC-IBS had CD-associated antibodies, suggesting that gluten sensitivity might mediate IBS symptoms; further studies are needed.
Authors:
Brooks D Cash; Joel H Rubenstein; Patrick E Young; Andrew Gentry; Borko Nojkov; Dong Lee; A Hirsohi Andrews; Richard Dobhan; William D Chey
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Webcasts     Date:  2011-07-14
Journal Detail:
Title:  Gastroenterology     Volume:  141     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-04     Completed Date:  2011-11-28     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1187-93     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Uniformed Services University of the Health Sciences, National Naval Medical Center, Bethesda, Maryland 20889-5000, USA. brooks.cash@med.navy.mil
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MeSH Terms
Descriptor/Qualifier:
Adult
Autoantibodies / blood
Biopsy
Case-Control Studies
Celiac Disease / diagnosis,  epidemiology*,  immunology,  pathology
Chi-Square Distribution
Colonoscopy
Duodenum / pathology
Female
Gliadin / immunology
Humans
Irritable Bowel Syndrome / diagnosis,  epidemiology*,  pathology
Logistic Models
Male
Middle Aged
Odds Ratio
Prevalence
Prospective Studies
Risk Assessment
Risk Factors
Transglutaminases / immunology
United States / epidemiology
Grant Support
ID/Acronym/Agency:
K23 DK079291/DK/NIDDK NIH HHS; K23 DK079291-01/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Autoantibodies; 9007-90-3/Gliadin; EC 2.3.2.13/Transglutaminases; EC 2.3.2.13/tissue transglutaminase 2, human
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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